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Objective To observe the effects of functional ambulation training in a realistic environment based on the activities of daily living among stroke patients with hemiplegia.Methods Thirty-two stroke survivors with hemiplegia were randomly divided into an experimental group and a control group,each of 16.Both groups were given routine rehabilitation training,while the experimental group was additionally given functional ambulation training based on the activities of daily living in a realistic environment for 60 min per day,five days a week for six weeks.Both groups were evaluated using the mini-mental state examination (MMSE),the Holden walking functional class assessment (HWFCA),the Berg balance scale (BBS),functional gait assessment (FGA),the 5 times sit to stand test (FTSST),the timed up and go test (TUGT),and rated using the specific activity balance confidence scale (ABC) and the modified Barthel index (MBI).Results Before the training,no significant differences between the two groups were found in terms of any of the measurements.After the six weeks of training,significant improvement was observed in all of the outcome measures except the MMSE and the HWFCA,with the experimental group scoring significantly better,on average,than the control group.Conclusion When combined with routine rehabilitation training,functional ambulation training based on the activities of daily living in a realistic environment can significantly enhance the functional gait,balance and postural control of stroke survivors.This should facilitate their activities in daily life and improve their confidence in maintaining their balance.
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Objective To study the factors affecting the activities of daily life (AOL) of patients after the first stroke of cerebral infarction in order to formulate the intervention strategy for improving the capability of ADL of patients. Method A total of 149 patients with the first stroke of cerebral infarction admitted from Oct. 2008 to Dec.2008 were enrolled in this study. The demographics of patients, cerebral infarction risk factors, apopletic score as per National Institute of Health stroke scale (NIHSS), white blood cell count (WBC) and plasma glucose (PG) were recorded on the first day of admission, and many other laboratory examinations were done on the next morning. The occurrences of infection in lung and urinary tract, and atrial fibrillation were recorded during hospi-talization. The NIHSS score and score of Glasgow Coma Scale (GCS) were taken within 24 hours after admission, on the 14th day and at the end of the third month after cerebral infarction respectively. Barthel index (BI) was taken in the second week as well as at the end of third month by follow-up in the OPD or by telephone. The correlation analysis and multiple linear stepwise regression analysis were used to find the risk factors. Results The PG level, WBC count and NIHSS score were independently associated with ADL in the second week as well as at the end of the third month after cerebral infarction. Besides, the urinary tract infection during hospital stay was also independently associated with ADL at the end of the third month after cerebral infarction. Conclusions The plasma glucose level, WBC count, NIHSS score and urinary tract infection are the risk factors. Positive measures should be taken to control these risk factors so as to improve the capability of ADL of the patients after cerebral infarction.
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OBJECTIVE:To observe the effects of different concentration of human urinary kallikrein on blood pressure when used for acute cerebral infarction. METHODS: By a non-randomized historical control study,the blood pressure variation of 34 patients on day one after treatment with low concentration (0.06%) of human urinary kallikrein was observed,the occurrence of hypotension in this group was compared with that of another 47 patients (control) treated with high concentration (0.3%) of human urinary kallikrein. RESULTS: The reduction of blood pressure in low concentration group was less obvious than in the high-concentration group. However,hypotension was noted in both groups when angiotensin-converting enzyme inhibitor (ACEI) hypotensive drugs were used concomitantly. CONCLUSION: Human urinary kallikrein for acute cerebral infarction can transiently down-regulate blood pressure slightly,but its effect on blood pressure can be lowered by suitable reduction of its concentration;at any concentration,it can result in hypotension if used in combination with ACEI.